<?php 
if (isset($message)) { ?>
<div class="alert alert-error">
  <?php echo $message ?>
</div>
<?php }?>
	<form class="form-horizontal validating-form" id="SignupForm" name="SignupForm" action="<?php echo controller_base_path($requestContext); ?>/Public/signup" method="post" >
		<fieldset>
			<legend>Sign Up and make connections through your goals</legend>
			<div class="control-group">
				<label class="control-label" for="firstName">First Name</label>
				<div class="controls">
					<input type="text" id="firstName" name="firstName" class="required" />
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="lastName">Last Name</label>
				<div class="controls">
					<input type="text" id="lastName" name="lastName" class="required" />
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="email">Email</label>
				<div class="controls">
					<input type="text" id="email" name="email"  class="required"/>
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="emailConf">Email confirmation</label>
				<div class="controls">
					<input type="text" id="emailConf" name="emailConf"  class="required"/>
					<p class="help-block">Email confirmation</p>
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="password">Password</label>
				<div class="controls">
					<input type="text" id="password" name="password"  class="required"/>
				</div>
			</div>
			
			<div class="control-group">
				<label class="control-label" for="inlineCheckboxes">I want to </label>
				<div class="controls">
					<label class="checkbox inline">
						<input type="checkbox" name="wantTo_pursue" value="1" />Pursue my goal
					</label>
					<label class="checkbox inline">
						<input type="checkbox" name="wantTo_mentor" value="2" />Mentor/Advise
					</label><br />
					<label class="checkbox inline">
						<input type="checkbox" name="wantTo_collaborate" value="4" />Collaborate
					</label>
					<label class="checkbox inline">
						<input type="checkbox" name="wantTo_coordinate" value="8" />Coordinate
					</label>
				</div>
			</div>

			<div class="control-group">
				<div class="controls">
					<button type="submit" class="btn">Sign Up</button>
					<p class="help-block">By clicking Sign Up, you agree to our Terms  and Policies.</p>
				</div>
			</div>

		</fieldset>
	</form>

<script src="http://jzaefferer.github.com/jquery-validation/jquery.validate.js" type="text/javascript" ></script>
<script type="text/javascript">
// FYI jQuery: multiple $(document).ready() is possible.
$(document).ready(function() {
	$(".validating-form").validate();
});
</script>